Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 2,884,224 | 22 | 119 | 2,884,365 | ||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 37,405,830 | 40,921,301 | 48,724,664 | 59,723,428 | 73,371,434 | 260,146,657 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 40,290,054 | 40,921,301 | 48,724,664 | 59,723,450 | 73,371,553 | 263,031,022 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 263,031,022 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 40,290,054 | 40,921,301 | 48,724,664 | 59,723,450 | 73,371,553 | 263,031,022 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6,585 | 6,585 | ||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 6,585 | 6,585 | ||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 40,290,054 | 40,921,301 | 48,731,249 | 59,723,450 | 73,371,553 | 263,037,607 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART V, LINE 2B: | THE ORGANIZATION UTILIZES LCMC HEALTH (EIN: 94-3480131) , THE SYSTEM PARENT, AS ITS DESIGNATED COMMON PAYMASTER FOR PAYROLL ADMINISTRATION, WAGE REPORTING, AND ALL EMPLOYMENT TAX COMPLIANCE FUNCTIONS. AS THE SYSTEM PARENT, LCMC HEALTH ADMINISTERS THESE COMPLIANCE FUNCTIONS ON BEHALF OF THE ENTIRE SYSTEM. ACCORDINGLY, THE 227 EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENT THE NUMBER OF FORMS W-2 FILED BY ORGANIZATION A, AS COMMON PAYMASTER, ON BEHALF OF THIS ORGANIZATION FOR THE REPORTING YEAR. |
| FORM 990, PART VI, SECTION A, LINE 6 | PRIOR TO FEBRUARY 6, 2017, CHILDREN'S HOSPITAL WAS THE SOLE MEMBER OF ITS AFFILIATE, CHILDREN'S HOSPITAL ANESTHESIA CORPORATION (CHAC). EFFECTIVE FEBRUARY 6, 2017, LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC) AND CHILDREN'S EXECUTED A MEMBER SUBSTITUTION AGREEMENT WHEREBY LCMC BECAME THE SOLE MEMBER OF CHILDREN'S HOSPITAL ANESTHESIA CORPORATION. AFTER THE MEMBER SUBSTITUTION, CHAC BEGAN DOING BUSINESS UNDER THE NAME LCMC HEALTH ANESTHESIA CORPORATION (LHAC). |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD DIRECTOR APPOINTS ALL OF THE OTHER MEMBERS OF THE BOARD. LOUISIANA CHILDREN'S MEDICAL CENTER IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL ANESTHESIA CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | NOTWITHSTANDING ANY PROVISION OF LAW OR THESE THIRD AMENDED AND RESTATED BY-LAWS TO THE CONTRARY, THE BOARD OF DIRECTORS MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE PRIOR WRITTEN APPROVAL OF THE SOLE MEMBER. (A)ADOPT, APPROVE OR AMEND ANY OPERATING, CAPITAL OR CASH FLOW BUDGET OF THE CORPORATION; (B)AUTHORIZE OR APPROVE ANY INSTITUTIONAL AFFILIATION; (C)AUTHORIZE THE ADMISSION OF ANY NEW MEMBER; (D)AUTHORIZE THE CORPORATION TO ENGAGE IN, OR ENTER INTO, ANY TRANSACTION PROVIDING FOR THE SALE, MORTGAGE, PLEDGE, HYPOTHECATION, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; (E)ADOPT A PLAN OF MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER CORPORATION; (F)ADOPT A PLAN OF DISSOLUTION, LIQUIDATION, AND/OR DISTRIBUTION OF THE ASSETS OF THE CORPORATION; (G)ORGANIZE, ACQUIRE OR DISSOLVE, OR AUTHORIZE THE ORGANIZATION, ACQUISITION OR DISSOLUTION OF, ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; (H)ADOPT, APPROVE OR AMEND THE ARTICLES OF INCORPORATION OR THESE THIRD AMENDED AND RESTATED BY-LAWS; (I)REMOVE THE PRESIDENT OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 8A | THE BOARD OF CHILDREN'S HOSPITAL ANESTHESIA CORPORATION DOES NOT HAVE SCHEDULED MEETINGS. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE BOARD OF CHILDREN'S HOSPITAL ANESTHESIA CORPORATION DOES NOT HAVE SCHEDULED MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY THE ACCOUNTING STAFF OF LCMC. THE ORGANIZATION'S FORM 990 WAS PRESENTED TO ALL MEMBERS OF THE ORGANIZATION'S BOARD FOR REVIEW VIA EMAIL LINK TO A SECURE DROP BOX. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, A LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES IS COMPILED BY THE LCMC CORPORATE COMPLIANCE DEPARTMENT. THOSE IDENTIFIED INDIVIDUALS ARE SENT A COMPLIANCE QUESTIONNAIRE TO IDENTIFY THE POTENTIAL FOR ANY CONFLICTS. CORPORATE COMPLIANCE MONITORS RESPONSES AND FOLLOWS UP WITH INDIVIDUALS AS NEEDED TO ENSURE COMPLETION OF THE QUESTIONNAIRE. THE RESULTS OF THESE ARE REVIEWED BY THE LCMC HEALTH CORPORATE COMPLIANCE DEPARTMENT TO ENSURE THAT ANY CONFLICTS ARE IDENTIFIED AND ADDRESSED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CORPORATION RELIES ON COMPARABLE DATA FROM UNRELATED ENTITIES TO DETERMINE THE AMOUNT OF COMPENSATION FOR ITS EXECUTIVES AND DOCUMENTATION IS MAINTAINED REGARDING THE DETERMINATION OF THESE AMOUNTS. THE FINAL DECISION REGARDING THE AMOUNT OF COMPENSATION IS SUBJECT TO APPROVAL OF THE LCMC EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 18 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 1,250. MANAGEMENT AND GENERAL EXPENSES 2,916. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,166. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 31,372. MANAGEMENT AND GENERAL EXPENSES 32. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,404. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 13,943,006. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,943,006. MEDICAL DIRECTOR FEES: PROGRAM SERVICE EXPENSES 315,570. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 315,570. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,443,245. MANAGEMENT AND GENERAL EXPENSES 18,583. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,461,828. RECRUITMENT SERVICES: PROGRAM SERVICE EXPENSES 100,343. MANAGEMENT AND GENERAL EXPENSES 3,625. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 103,968. FREIGHT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 32. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32. |
| FORM 990, PART XII, LINE 2C | LCMC'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF ITS SUBSIDIARIES' FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR. THIS HAS NOT CHANGED FROM THE PREVIOUS YEAR. |
| Software ID: | |
| Software Version: |